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UNDERTAKING/ DECLARATION TO BE OBTAINED DURING INTERVIEW/JOINING Date: Recruitment Manager Human Resources Management Group ICICI Bank Ltd Mumbai Subject:- Declaration and Undertaking Dear Sir, With reference to my application for an appointment in the services of ICICI Bank, I hereby declare and undertake the following: (Please fill in as “Not Applicable” in case there is nothing pending) 1. There is no case pending against me in any Court of Law or in any Police Station. Further, there was no FIR/Investigation against me in the past and I was never arrested and or convicted in any Court of law. If yes, please mention details of such pending case/s and or reasons leading to such FIR/Investigation/arrest/conviction in the past- including period of detention, if any -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- ------------- 2. There is no case pending against me for investigation with my previous employer(s)--------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------- 3. I have never been a member of any Banned Outfits declared by the Government. If yes, please mention details. If yes, please mention details -------------------------------------------------------------------- -------------------------------------------------------------------- -------------------------------------------------------------------- --------------------------------------------------------------------

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UNDERTAKING/ DECLARATION TO BE OBTAINED DURING INTERVIEW/JOINING

UNDERTAKING/ DECLARATION TO BE OBTAINED DURING INTERVIEW/JOINING

Date:

Recruitment Manager

Human Resources Management Group

ICICI Bank Ltd

Mumbai

Subject:- Declaration and Undertaking

Dear Sir,

With reference to my application for an appointment in the services of ICICI Bank, I hereby declare and undertake the following: (Please fill in as Not Applicable in case there is nothing pending)

1. There is no case pending against me in any Court of Law or in any Police Station. Further, there was no FIR/Investigation against me in the past and I was never arrested and or convicted in any Court of law.If yes, please mention details of such pending case/s and or reasons leading to such FIR/Investigation/arrest/conviction in the past- including period of detention, if any ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

2. There is no case pending against me for investigation with my previous employer(s)-----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

3. I have never been a member of any Banned Outfits declared by the Government. If yes, please mention details. If yes, please mention details

------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------

4. The information furnished by me on my previous employment/s, compensation earned and qualification gained is without any discrepancy/ies 5. I authorize ICICI Bank to procure my credit information from Credit Information Bureau of India Limited (CIBIL) or any other recognized credit information company

I am aware that in case of any discrepancies found out by the Bank at a later date on any of the above declarations made by me, my candidature as well as subsequent continuation in the services of the Bank- as the cases may be- would liable to be cancelled and or terminated, at any time, without giving any reason and I would be bound by such decision of the Bank.

Thanking You

Yours faithfully

Signature of the Applicant

Applicant Name:

Contact No: